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EUS-guided antegrade stenting combined with EUS-guided hepaticogastrostomy for malignant biliary obstruction. (a) The left intrahepatic bile duct was punctured with a 19-gauge needle under EUS visualization. (b) The guidewire was advanced to the duodenum through the stricture. (c) An uncovered metal stent was antegradely placed at the stricture site above the papilla. (d) An 8-Fr dedicated plastic stent was placed across the hepaticogastrostomy route
